A recent report indicates hospital patients in the United States are the victims of at least, on average, one medication mistake every day. Medication errors can jeopardize patient safety and cost hundreds of millions of dollars in drug-related injuries and health care costs. These alarming figures are part of a recent report, and one of the authors says the findings are disturbing.
With four billion prescriptions filled every year in the United States, there is a large margin of error.
Dr. Albert Wu is an Internist and Professor of Health Policy at Johns Hopkins University in Baltimore, Maryland. "There are so many medications being prescribed today. Patients on average see many physicians -- especially older patients, or people who have chronic illnesses. They may see ten different doctors or more in a year. "
Dr. Wu is one of the authors of the report and he found problems occurring at every stage -- from the manufacturer and government regulators, to health insurance organizations, druggists and medical personnel.
He relates some of the ways that errors occur. "The patient gets the wrong medicine, the wrong dose, it is administered in a combination of other medications where it should not be, perhaps it is administered to the wrong person."
The report was commissioned by the Institute of Medicine, which advises the U.S. government and health care providers. Data submitted by 8,000 hospitals in the United States shows at least one and a half-million people are harmed every year by drug-related errors.
One of the recommendations of changes to be made by the year 2010: handwritten prescriptions should be replaced by computerized orders. Johns Hopkins' Medical Safety Officer Dr. Robert Feroli says tracking prescriptions electronically will install safeguards along the way:
"One of the things we're doing with the computer that's not available as a handwritten order is that the computer can say, 'Here's a drug interaction…are you sure?’ Or, ‘There's a dose that doesn't seem right. Are you sure, doctor, this is what you want?' Again, another error checking system."
The Institute of Medicine estimates that only six percent of U.S. health care institutions use electronic prescribing. Yet technology is only as effective as the human beings who use it.
Dr. Feroli says patients should provide the physician with a list of the medications they're already taking or better yet, bring in the medications themselves. "What you can do is uncover a variety of problems that actually might be the reason why the patient is to see the doctor to begin with.”
At Johns Hopkins, clinical pharmacist Amy Hatfield is part of the medical team caring for cancer patients. She would like to see up-to-the-minute computerized analysis at the bedside. "Often our patients come in and we don't have all their past medical history because they've never been treated in our hospital system before. That would be very helpful for us," she says.
Johns Hopkins Hospital is ranked number one among America's best hospitals. Yet for all its world-class medical expertise, Dr. Albert Wu says patients at Hopkins and other medical facilities could do more to improve their own care.
"I think that patients are too deferential and just because the doctor knows more about medicine than you do, does not mean that he or she knows everything about you,” says the doctor. “If patients need to speak up, doctors need to listen up: pay more attention to what the patient is saying and take that into account in making their decisions.”